| BACKGROUND:Colorectal carcinoma is a common malignant tumor, and more occurrence in middle-aged and old population,but not rare in young adult. Colorectal carcinoma in youth is different in clinical,pathologic features,etc,compared with middle-aged and old patients. Colorectal carcinoma in youth was developed rapidly, occult symptoms and a high misdiagnosis rate. The majority patients were in advanced stage with a poor prognosis when the diagnosis was confirmed. The incidence of colorectal carcinoma in youth is going up in recent years, so it has been paid more attention to explore its clinical and pathologic features and early diagnosis.OBJECTIVE:To explore the characteristics of clinical,histopathol- gical staging in young people with colorectal cancer.METHODS:380 cases of colorectal cancer collecting in Tumor Hospital of Guangxi Medical University from January 2002 to March 2008 were divided into three groups:97 cases in youth group (15-44 years old),118 cases in middle-aged group (45-59 years old),165 cases in older group (≥60 years old). It were retrospectively analyzed to the age,sex,occupation,course of disease,clinical manifestations,misdiagnosis in other hospitals,inspection means,tumor location,pathological characteristics and clinical stage in different groups.RESULTS:The colorectal cancer was found mainly in middle-aged and elderly,male-dominated.The incidence of colorectal cancer in youth group of this study was significantly higher than that in domestic and abroad report and a larger proportion was found in female in this group.The incidence of colorectal cancer was significantly higher in farmers and lower in the cadres in the young group than that in the middle-aged and elderly group (P<0.05).The clinical symptoms hadn't significant difference compared with middle-aged and elderly group (P>0.05),but the proportion of abdominal distention-pain was more than the middle-aged and elderly group.There was a positive correlation between the weight loss and Dukes staging(rs=0.128,P=0.013),and there wasn't correlation between the course of disease and Dukes staging (rs= -0.069,P=0.182).The misdiagnosis rate was 55.7% in youth group and it was significantly higher than that in the middle-aged and elderly group (P<0.05);The examination using FOBT,CEA,electronic colonoscopy hadn't significant differences in three groups (P>0.05),the positive rate of electronic colonoscopy was significantly higher than FOBT and CEA examination (P<0.05);The location of colorectal cancer development was mainly in rectum in three groups.The well-differentiated tubular adeno- carcinoma had no significantly difference in those groups(P>0.05).In young group,some pathologic types,for the example, the poorly differ- entiated mucinous adenocarcinoma,the undifferentiated adenocarcino- ma,the signetring cell carcinoma,the malignant melanoma were signi- ficantly higher than that in middle-aged and elderly groups (P<0.05).The Dukes staging of A + B were significantly lower but the Dukes staging of C1and C2 were significantly higher than that in the middle-aged and eld- erly group (P <0.05).In youth group,the rate of lymph node metastasis was significantly higher than that in the middle- aged and elderly group (P<0.05).CONCLUSIONS:The proportion of young female' patients with colorectal cancer is more than that in the middle-aged and elderly groups in this study.The risk of colorectal cancer in young people about farmers and individuals of low-income is higher than that in the middle-aged and elderly;In young people the misdiagnosis rate is higher,and there are more higher degree of the clinical stages.The examination with electron- ic colonoscopy is still very important.Young patients with colorectal cancer have poor pathologic differentiation,high degree of malignant and the higher rate of lymph node metastasis.Therefore,we should actively do to propagandize the knowledge of colorectal cancer,to deepen grass- roots medical workers' realization of colorectal cancer and perform some necessary examinations(the digital rectal examination;fecal occult blood and electronic colonoscopy examination;the biopsy examination),to institute a rational and effective treatment procedures to high-risk popula- tion so as to enhance young people with colorectal cancer's early diagno- sis and treatment.
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